Research in January's issue of Gut finds that short term synbiotic treatment of active ulcerative colitis results in the improvement of the full clinical appearance of chronic inflammation in patients receiving this therapy.

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Ulcerative colitis (UC) is an acute and chronic inflammatory disease of the large bowel with unknown etiology.

Therefore, modulation of bacterial communities on the gut mucosa, through the use of probiotics and prebiotics, may be used to modify the disease state.

Dr Furrie and colleagues from Dundee in Scotland developed a synbiotic for use in ulcerative colitis patients combining a probiotic, Bifidobacterium longum, isolated from healthy rectal epithelium, and a prebiotic (Synergy 1), a preferential inulin-oligofructose growth substrate for the probiotic strain.

The researchers arranged a course of treatment in a double blinded randomized controlled trial using 18 patients with active ulcerative colitis for a period of 1 month.

The research team scored clinical status and collected rectal biopsies before and after treatment.

The team also measured transcription levels of epithelium related immune markers.

The researchers found that the sigmoidoscopy scores (scale 0–6) were reduced in the test group (start 4.5 (1.4), end 3.1 (2.5)) compared with placebo (start 2.6 (2.1), end 3.2 (2.2)).

In addition, the team noted that mRNA levels for human beta defensins 2, 3, and 4, which are strongly upregulated in active ulcerative colitis, were significantly reduced in the test group after treatment.

Tumour necrosis factor and interleukin 1, which are inflammatory cytokines that drive inflammation and induce defensin expression, were also significantly reduced after treatment.

The research team found that biopsies in the test group had reduced inflammation and regeneration of epithelial tissue.

Dr Furrie concluded, "Short term synbiotic treatment of active ulcerative colitis resulted in improvement of the full clinical appearance of chronic inflammation in patients receiving this therapy."